Acquiring health insurance is harder than it seems
For most people, acquiring health insurance is a must in order to handle the high costs of medical care.
It’s not as easy as it sounds, though.
Prices and coverages vary, just as people’s incomes do. Sometimes, an employer doesn’t offer an insurance plan to its workers. And sometimes if there is a plan, it’s too pricey for an employee.
But there are places to go and/or people to see for those who find themselves in such a quandary.
And some expected assistance may be uncovered as well.
Under the Affordable Care Act passed by Congress in 2010 — also known as Obamacare, after then-President Barack Obama — the Health Care Marketplace was established to help consumers seek insurance in their price range, with government subsidies available to those who meet certain qualifications.
The search can be done online by an individual or through the assistance of an agent.
“The way it works is, if what they charge where you work — and it’s for the employee only — is more than 9½ percent of your income, then you’re eligible for a subsidy to the Marketplace under the Affordable Care Act plan,” said Lee Hitchings, president and co-owner of the Hitchings Insurance Agency in Findlay. “We write quite a few of those; we probably wrote 300 or 400 in this open enrollment.
“The issue with that is the open enrollment goes from Nov. 1 to Dec. 15 and that has concluded. So, if you miss that open enrollment, you only would be able to get what they call a short-term health plan. And the issue with the short-term health plans is they don’t cover anything pre-existing and they are medically underwritten. But you can keep them up to 12 months.”
Hitchings said some unexpected treasure can sometimes be found through Obamacare.
“We’ve had some where the subsidy was worth more than the premium, so they could get (a policy) at almost zero cost, or less than $100 a month, because of the subsidy,” he said.
Certain circumstances can allow for help as well.
“Let’s say you have a job and, for example, I’ve got a couple coming in tomorrow; he’s retiring Feb. 1, that creates a special enrollment period,” Hitchings said. “That person then can go ahead and get signed up outside of the open enrollment. So, if you have a qualifying event — you have a baby, you get married — then you can go ahead and get that person signed up at that time. But you have to do it within 60 days of the event.”
The insurance search can be quite complicated, which is why the aid of an agent may be helpful.
“We have what’s called a broker portal, an online system where we actually go into our agency website and we just go and start their application, log in to HealthCare.gov and get their subsidy amount and then we can bring it back and finish the application here,” Hitchings said. “So, it’s pretty easy from our standpoint. If they want help or assistance, they can come to us and we can help them look up doctors and providers and things like this. It’s the same price, whether you work with an agent or go through HealthCare.gov. A lot of people like the assistance of an agent to help them navigate things.”